{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T21:36:46Z","timestamp":1778535406490,"version":"3.51.4"},"reference-count":39,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"One Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Wastewater surveillance systems have become an important component of COVID-19 outbreak monitoring in high-income settings. However, its use in most low-income settings has not been well-studied. This study assessed the feasibility and utility of wastewater surveillance system to monitor SARS-CoV-2 RNA in Addis Ababa, Ethiopia. The study was conducted at nine Membrane Bio-reactor (MBR) wastewater processing plants. The samples were collected in two separate time series. Wastewater samples and known leftover RT-PCR tested nasopharyngeal swabs were processed using two extraction protocols with different sample conditions. SARS-CoV-2 wastewater RT-PCR testing was conducted using RIDA GENE SARS-CoV-2 RUO protocol for wastewater SARS-CoV-2 RNA testing. Wastewater SARS-CoV-2 RNA RT-PCR protocol adaptation, optimization, and detection were conducted in an Addis Ababa, Ethiopia context. Samples collected during the first time series, when the national COVID-19 case load was low, were all negative. Conversely, samples collected during the second time series were all positive, coinciding with the highest daily reported new cases of COVID-19 in Ethiopia. The wastewater-based SARS-CoV-2 surveillance approach is feasible for Addis Ababa. The COVID-19 wastewater based epidemiological approach can potentially fill the evidence gap in distribution and dynamics of COVID-19 in Ethiopia and other low-income settings.<\/jats:p>","DOI":"10.3390\/ijerph19148515","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T20:52:41Z","timestamp":1657659161000},"page":"8515","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Community Wastewater-Based Surveillance Can Be a Cost-Effective Approach to Track COVID-19 Outbreak in Low-Resource Settings: Feasibility Assessment for Ethiopia Context"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5641-8797","authenticated-orcid":false,"given":"Solomon","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Microbiology, Immunology and Parasitology, St. Paul\u2019s Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6264-9695","authenticated-orcid":false,"given":"Esayas Kebede","family":"Gudina","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jimma University, Jimma P.O. Box 378, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Addisu","family":"Gize","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Parasitology, St. Paul\u2019s Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5906-3343","authenticated-orcid":false,"given":"Abde","family":"Aliy","sequence":"additional","affiliation":[{"name":"National Animal Health Diagnostic and Investigation Center, Sebeta P.O. Box 04, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birhanemeskel Tegene","family":"Adankie","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Parasitology, St. Paul\u2019s Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wondwossen","family":"Tsegaye","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Parasitology, St. Paul\u2019s Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5627-9675","authenticated-orcid":false,"given":"Gadissa Bedada","family":"Hundie","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Parasitology, St. Paul\u2019s Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahteme Bekele","family":"Muleta","sequence":"additional","affiliation":[{"name":"Department of Surgery, St. Paul\u2019s Hospital Millennium, Medical College, Addis Ababa P.O. Box 1271, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tesfaye Rufael","family":"Chibssa","sequence":"additional","affiliation":[{"name":"National Animal Health Diagnostic and Investigation Center, Sebeta P.O. Box 04, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rediet","family":"Belaineh","sequence":"additional","affiliation":[{"name":"National Animal Health Diagnostic and Investigation Center, Sebeta P.O. Box 04, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demessa","family":"Negessu","sequence":"additional","affiliation":[{"name":"National Animal Health Diagnostic and Investigation Center, Sebeta P.O. Box 04, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dereje","family":"Shegu","sequence":"additional","affiliation":[{"name":"National Animal Health Diagnostic and Investigation Center, Sebeta P.O. Box 04, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2743-7555","authenticated-orcid":false,"given":"Guenter","family":"Froeschl","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universit\u00e4t, 80802 Munich, Germany"},{"name":"Partner Site Munich, German Center for Infection Research (DZIF), 80802 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Wieser","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universit\u00e4t, 80802 Munich, Germany"},{"name":"Partner Site Munich, German Center for Infection Research (DZIF), 80802 Munich, Germany"},{"name":"Max von Pettenkofer-Institute, Ludwig-Maximilians-Universit\u00e4t, 80802 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.1002\/mco2.115","article-title":"COVID-19: A systematic review and update on prevention, diagnosis, and treatment","volume":"3","author":"Aliabadi","year":"2022","journal-title":"MedComm"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Mangindaan, D., Adib, A., Febrianta, H., and Hutabarat, D.J.C. 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